Download Hepatitis and TB

HIV AND TB
TUBERCULOSIS
Caused by bacterium called Mycobacterium
tuberculosis
 Usually attacks lungs, but can attack any part of
the body, such as kidney, spine, brain
 Can be fatal if not treated

TRANSMISSION


Through the air:
person to person
(coughing, sneezing,
singing)
People nearby inhale
bacteria and become
infected
But not through:
• Shaking hands
• Sharing food or drink
• Bed linens or toilet
seats
• Sharing
toothbrushes
• Kissing
2 TB-RELATED CONDITIONS

Latent TB infection (LTBI)

TB Disease
LATENT TB INFECTION





TB bacteria lives in body but doesn’t make person
sick
No symptoms
Positive reaction to tuberculin skin test or special TB
blood test
Not infectious
If bacteria becomes active, person WILL become sick
w/TB disease
TB DISEASE
TB Bacteria are active (multiplying in body)
 People w/bacteria may spread it to any people
they spend time with
 Some can have disease soon after becoming
infected (within weeks) before immune system
can fight the TB bacteria
 Others get sick years later, when immune system
becomes weak for other reasons
 Risk is higher for those w/weak immune systems
(i.e., HIV)

COMPARISON BETWEEN LATENT INFECTION
AND TB DISEASE
Latent TB Infection
A Person w/TB Disease
Has no symptoms
Has symptoms that may
include:
-a bad cough that lasts 3 wks
or more
-pain in the chest
-coughing up blood or sputum
-weakness or fatigue
-weight loss
-no appetitie
-chills
-fever
-sweating at night
Does not feel sick
Usually feels sick
Can’t spread TB bacteria to
others
May spread TB bacteria to
others
COMPARISON BETWEEN LATENT
INFECTION AND TB DISEASE
Latent TB Infection
A Person w/TB Disease
Usually has a skin test or blood
test result indicating TB
infection
Usually has a skin test or blood
test result indicating TB
infection
Has a normal chest x-ray and a
negative sputum smear
May have an abnormal chest xray, or a positive sputum smear
or culture
Needs treatment for latent TB
infection to prevent active TB
disease
Needs treatment to treat active
TB disease
TREATMENT

For Latent TB Infection
Though no TB disease, to prevent development of TB
disease in the future, often prescribed treatment.
 Less bacteria present, so treatment relatively easy
 INH (isoniazid)

Preferred regiment of 9 months
 Children and people w/HIV may need to take INH for
longer

TREATMENT

For TB Disease





Large amount of bacteria present
Several drugs can be used, for 6-12 months
Drugs must be taken exactly as prescribed
Must finish course of treatment or germs that are
still alive may become resistant to the drugs
TB that is resistant to drugs is harder and more
expensive to treat
TESTING & DIAGNOSIS

TB Blood Tests
aka Interferon-Gamma release assays or IGRAs
 Measures how the immune system reacts to the
bacteria that causes TB
 Only 1 visit required
 Results in 24-48 hrs


Mantoux tuberculin skin test
Small amount of tuberculin injected into skin in
lower part of the arm
 Must return w/in 48-72 hrs to have health care
provider observe reaction on arm

WHO SHOULD GET TESTED
Have spent time w/person known or suspected to
have active TB disease
 Have HIV or other problem w/weakened immune
system
 Have symptoms of active TB disease
 From a country where active TB disease is
common (Latin America, Africa, Asia, Eastern
Europe, Russia)
 Live in areas where active TB disease is more
common---homeless shelters, migrant farm camp,
prison or jail, some nursing homes
 Inject illegal drugs

TB AND HIV CO-INFECTION
TB is one of leading causes of death among
people infected w/HIV
 HIV and TB can work together to shorten the life
of an infected person
 A person w/untreated latent TB infection and
HIV is much more likely to develop active TB
disease than someone w/out HIV
 Among those w/latent TB infection, HIV infection
is the strongest known risk factor for progressing
to active TB disease
 Can be effectively treated

LINK BETWEEN STDS AND HIV
Individuals infected with STDs are 2-5 Xs more
likely than uninfected individuals to acquire HIV
infection if they are exposed to the virus through
sexual contact
 If an HIV-infected person is also infected
w/another STD, that person is more likely to
transmit HIV through sexual contact than
another HIV-infected person

The presence of other STDs increases the
likelihood of both transmitting and
acquiring HIV
LINK BETWEEN STDS AND HIV

Increased Susceptibility

Increased Infectiousness
STD TREATMENT SLOWS THE SPREAD OF
HIV
STD treatment reduced an individual’s ability to
transmit HIV
 Herpes can make people more susceptible to HIV
infection, and make HIV-infected people more
infectious

IMPLICATIONS FOR HIV PREVENTION




Early detection and treatment of curable STDs should
become a major, explicit component of comprehensive
HIV prevention programs at national, state, and local
levels;
In areas where STDs that facilitate HIV transmission
are prevalent, screening and treatment programs
should be expanded;
HIV testing should always be recommended for
individuals who are diagnosed with or suspected to
have an STD.
HIV and STD prevention programs in the United
States, together with private and public sector
partners, should take joint responsibility for
implementing these strategies.